title: Glucocorticoid-induced hyperglycemia.
abstract: Corticosteroid-induced hyperglycemia is a common medical problem that can lead to frequent emergency room visits, hospital admissions and prolonged hospital stay, in addition to the well known morbidity associated with hyperglycemia. However, the diagnosis and treatment of corticosteroid-induced hyperglycemia is surprisingly undervalued by most professionals, probably because of the lack of quality studies to determine specific strategies of action. In the present review, we discuss the pathophysiology of corticosteroid-induced hyperglycemia, focusing on diverse patterns of hyperglycemia induced by the different formulations, and provide clues for diagnosis based on the duration of treatment and the administration schedule of corticosteroids. We propose a treatment strategy based on both the pathophysiology of the process and the mechanism of action of different corticosteroids, and take into account dosing and administration timing to predict the duration of therapy. Finally, we propose treatment goals that differ slightly between the transient and continuous use of corticosteroids based on evidence from clinical practice guidelines of diabetes care both in ambulatory and hospital settings.
authors.affiliation: Endocrinology and Nutrition Department, Hospital de la Santa Creu i San Pau, Barcelona, Spain; CIBER of Diabetes and Metabolic Diseases (CIBERDEM), Barcelona, Spain.
authors.forename: Antonio
authors.initials: A
authors.lastname: Perez
authors.forename: Sergio
authors.initials: S
authors.lastname: Jansen-Chaparro
authors.forename: Ignasi
authors.initials: I
authors.lastname: Saigi
authors.forename: M Rosa
authors.initials: MR
authors.lastname: Bernal-Lopez
authors.forename: Inka
authors.initials: I
authors.lastname: Miñambres
authors.forename: Ricardo
authors.initials: R
authors.lastname: Gomez-Huelgas
mesh_terms: D005938:Glucocorticoids / Q000009:adverse effects*; D006801:Humans; D006943:Hyperglycemia / Q000139:chemically induced* / Q000175:diagnosis / Q000628:therapy
chemical_list: D005938:Glucocorticoids
keywords: glucocorticoids; hyperglycemia; treatment strategy; 糖皮质激素，高血糖，治疗策略